University of Maryland Travma Yandal Programı Tanıtım Yazısı (The Trauma Fellowship Program)

Trauma/Surgical Critical Care Fellowship

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Fellowship Alumni

Contact the Program Coordinator

Program Director: William C. Chiu, MD
Program Coordinator: Stephanie Jordan

Originally, a Trauma Fellowship, the program is considered by many to be the premier clinical trauma training program. The fellowship evolved into the Surgical Critical Care Fellowship in October 1993 when it was accredited by the Accreditation Council for Graduate Medical Education (the parent body of the Residency Review Committee in Surgery). The clinical experience is based to a large degree at the R Adams Cowley Shock Trauma Center. The goal of the fellowship is to produce academic leaders in the areas of critical care and trauma.

Under the guidance of a strong faculty, fellows master the cutting edge techniques of critical care medicine including new methods of mechanical ventilation and extracorporeal support of failing lungs, kidneys and hearts. The fellow will learn to manage the severely brain-injured patient, and the critically ill surgical patient. The global critical care management of the multiply-injured trauma patient is a focal point of their fellowship experience. Experience is gained in the management of single and multiple transplant recipients as well as patients after open-heart cardiac surgery. Additionally, the fellow will manage the full spectrum of surgical patients in a major urban medical center.

The fellowship is a one-year program involving patient care, research, and education. The program includes the following rotations: three months of trauma surgery, two months in the Neuro-trauma Critical Care Unit, and two months in the Multi-trauma Critical Care Unit at the R Adams Cowley Shock Trauma Center; two months in the Surgical ICU, and one month in the Cardiothoracic ICU at the University of Maryland Medical Center; and two months of elective. Electives are available in trauma radiology, trauma anesthesiology, trauma infectious diseases, transesophageal echocardiography, pediatric, medical and neurosurgical ICU as well as in the experience of Emergency Medical Services. All electives are arranged and approved with the fellow's future career goals in mind.

The fellows become proficient in the evaluation of critically-ill and injured patients; the initiation of appropriate and complete diagnostic and treatment plans; the development and implementation of patient care plans; providing leadership which facilitates the interaction within the entire team of caregivers and with the patients and their families. The fellow has full responsibility as trauma team leader, gaining a broad range of experience in the management of blunt and penetrating trauma, and the use of FAST (Focused Assessment with Sonography for Trauma). Administratively, the fellows are expected to grasp the art and science of trauma team administration and to achieve a working understanding of the major issues in trauma care such as, resource allocation, costs and ethical dilemmas. Upon the completion of this one-year fellowship, fellows will have acquired the necessary knowledge and experience to make them eligible to sit for the Added Qualifications in Critical Care exam given by the American Board of Surgery.

Fellows may opt to remain for a second fellowship year where they are provided opportunities for research through the R Adams Cowley Shock Trauma Center research program, as well as an opportunity to enroll in a Master's Degree program through an affiliation with the Injury Prevention Department at the Johns Hopkins School of Public Health. Emergency Medical Services (EMS) and pre-hospital research opportunities are available through the National Study Center for Trauma and EMS and in cooperation with Maryland Institute for Emergency Medical Services System (MIEMSS). Additionally, a second fellowship year is available to gain more intense training in trauma patient care and management.

Patient Care

Fellows are expected to become proficient in the pre-operative assessment, operative, and post-operative management of the trauma patient. Fellows are expected to become clinically proficient in:

overall patient assessment
ventilator management
techniques of vascular access and monitoring
direction of the trauma and critical care team
Fellows are expected to become familiar with the didactic knowledge required to adequately care for the critical care and trauma patient. They should be able to define and defend their management plans.

Education

Fellows are expected to:

Participate in the education of the rotating residents and medical students as well as evaluate their performance.
Present cases to the faculty and staff at a monthly formal Morbidity and Mortality conference. Additionally, the fellow is expected to present cases of interest to visiting Grand Rounds professors.
Attend monthly journal club meetings led by the faculty.
Attend weekly didactic sessions.
Certify, or renew their certification, in ATLS as well as in the ATOM course.
Participate in a course on moderate sedation and complete the requisite number of cases.
Complete a one-day course on the proper use of Focused Assessment with Sonography for Trauma.
Take MCKKAP, a critical care in-training examination.
Research

Fellows will be provided a research mentor from among the faculty. Research mentors are assigned based on mutual areas of interest. Near the end of the year, fellows will be provided the opportunity to present their research to the faculty.

Education

Education is an integral component of the Program in Trauma's mission. The Program provides a comprehensive learning environment for School of Medicine students, residents and fellows - future physicians and trauma specialists who will apply their skills as leaders of trauma centers throughout the United States. Shock Trauma also serves as the principal training site for U.S. Air Force physicians, nurses, technicians and Special Operations medics prior to their deployment overseas.

Fellowship programs, together with student and resident rotations from national and international institutions, constitute a considerable educational responsibility. Over the past several decades graduates of the fellowship programs have become leaders in trauma care in the United States and abroad.

Undergraduate Medical Program

Third Year

All third-year medical students rotate on the trauma service to gain invaluable learning experience in injury and critical illness.

GSUR 530 is a one-month trauma team rotation that is required as part of the basic surgical clerkship. Students participate under supervision in the clinical resuscitation, diagnosis and management of trauma and emergency medicine.

Fourth Year

Fourth-year medical students rotate on the trauma service on an elective basis. The medial students participate in trauma resuscitation, clinical rounds, and all the didactic teaching (core curriculum lecture series, morbidity and mortality conferences, journal club, grand rounds, etc.) available to residents and fellows.

GSUR 546 01 Senior students may choose a one-month elective on the trauma surgery team.

Graduate Programs

Residency Training

Resident educational experiences of one to several months currently include 238 rotations from 25 parent programs.



Fellowships

The Trauma Fellowship, considered by many to be the world's premier clinical trauma training program, evolved into the ACGME-accredited (Accreditation Council for Graduate Medical Education) Surgical Critical Care/Trauma Fellowship in 1994. Based to a large degree at the Shock Trauma Center, the goal of the fellowship is to produce leaders in academic surgery in the area of critical care and trauma. Under the guidance of strong faculty, fellows master the cutting edge techniques of critical care medicine. The global management of the multiple trauma patient is the focus of the fellowship experience, a one-year program involving patient care, research and education.

A six-month Trauma Anesthesiology Fellowship involves patient care, education, and research. Electives are available in critical care medicine, hyperbaric medicine, acute pain management, and research. All electives are arranged and approved with the fellow's future career goals in mind.

The Shock Trauma program is considered by many to be the world's foremost Orthopaedic Trauma Fellowship. A one-year program, the primary goal of the Shock Trauma Orthopaedic Trauma Fellowship is to train orthopaedic surgeons to become clinically proficient in managing the musculoskeletal injuries of the severely or multiply injured patient in an interdisciplinary environment.

C-STARS Program (Center for the Sustainment of Trauma and Readiness Skills)

Shock Trauma has deep historical ties with the nation's armed forces through its physicians and nursing staff. We have maintained a working relationship with the physicians of institutions such as Walter Reed Army Medical Center and the Maryland National Guard for decades. These relationships have taken on new meaning in this period of actual and anticipated terrorist attacks.

Shock Trauma is host to the largest C-STARS program in the country, providing real-time training in trauma and critical care for U.S. Air Force physicians, nurses, OR technicians, Special Operations medics and chaplains prior to their deployment to the Middle East. Thirteen "permanent" Air Force personnel in several trauma and critical care specialties join the School of Medicine faculty and participate with the Program in Trauma faculty in training approximately 30 Air Force personnel per month from bases around the world. Relationships established and the cooperative learning environment have extended far beyond the classroom to include telemedicine consultations with military personnel in field hospitals in Iraq and Afghanistan and treatment of wounded soldiers upon their return to the United States.

alıntı : medschool.umaryland.edu/trauma/education.asp